TY - JOUR
T1 - Recurrence, postponing pregnancy, and termination rates after hyperemesis gravidarum
T2 - Follow up of the MOTHER study
AU - Nijsten, Kelly
AU - Dean, Caitlin
AU - van der Minnen, Loïs M.
AU - Bais, Joke M.J.
AU - Ris-Stalpers, Carrie
AU - van Eekelen, Rik
AU - Bremer, Henk A.
AU - van der Ham, David P.
AU - Heidema, Wieteke M.
AU - Huisjes, Anjoke
AU - Kleiverda, Gunilla
AU - Kuppens, Simone M.
AU - van Laar, Judith O.E.H.
AU - Langenveld, Josje
AU - van der Made, Flip
AU - Papatsonis, Dimitri
AU - Pelinck, Marie José
AU - Pernet, Paula J.
AU - van Rheenen-Flach, Leonie
AU - Rijnders, Robbert J.
AU - Scheepers, Hubertina C.J.
AU - Vogelvang, Tatjana
AU - Mol, Ben W.
AU - Roseboom, Tessa J.
AU - Koot, Marjette H.
AU - Grooten, Iris J.
AU - Painter, Rebecca C.
N1 - Funding Information:
BWM reports grants from the National Health and Medical Research Council (NHMRC) outside the submitted work. The rest of the authors have nothing to disclose.
Funding Information:
The MOTHER study was supported by a research grant from North West Hospital Group, Alkmaar, the Netherlands (Grant number: 2013T085). The follow‐up study was funded by a research grant from the Amsterdam Reproduction and Development (AR&D) research institute, Amsterdam UMC, the Netherlands (Project number: 23346).
Publisher Copyright:
© 2021 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG)
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/9
Y1 - 2021/9
N2 - Introduction: Hyperemesis gravidarum (HG) complicates 1% of pregnancies and has a major impact on maternal quality of life and well-being. We know very little about HG’s long-term impact after an affected pregnancy, including recurrence rates in future pregnancies, which is essential information for women considering subsequent pregnancies. In this study, we aimed to prospectively measure the recurrence rate of HG and the number of postponed and terminated subsequent pregnancies due to HG. We also aimed to evaluate if there were predictive factors that could identify women at increased risk for HG recurrence, and postponing and terminating subsequent pregnancies. Material and methods: We conducted a prospective cohort study. A total of 215 women admitted for HG to public hospitals in the Netherlands were enrolled in the original MOTHER randomized controlled trial and associated observational cohort. Seventy-three women were included in this follow-up study. Data were collected through an online questionnaire. Recurrent HG was defined as vomiting symptoms accompanied by any of the following: multiple medication use, weight loss, admission, tube feeding or if nausea and vomiting symptoms were severe enough to affect life and/or work. Outcome measures were recurrence, postponing, and termination rates due to HG. Univariable logistic regression analysis was used to identify predictive factors associated with HG recurrence, and postponing and terminating subsequent pregnancies. Results: Thirty-five women (48%) became pregnant again of whom 40% had postponed their pregnancy due to HG. HG recurred in 89% of pregnancies. One woman terminated and eight women (23%) considered terminating their pregnancy because of recurrent HG. Twenty-four out of 38 women did not get pregnant again because of HG in the past. Univariable logistic regression analysis identifying possible predictive factors found that having a western background was associated with having weight loss due to recurrent HG in subsequent pregnancies (odds ratio 12.9, 95% CI 1.3–130.5, p = 0.03). Conclusions: High rates of HG recurrence and a high number of postponed pregnancies due to HG were observed. Women can be informed of a high chance of recurrence to enable informed family planning.
AB - Introduction: Hyperemesis gravidarum (HG) complicates 1% of pregnancies and has a major impact on maternal quality of life and well-being. We know very little about HG’s long-term impact after an affected pregnancy, including recurrence rates in future pregnancies, which is essential information for women considering subsequent pregnancies. In this study, we aimed to prospectively measure the recurrence rate of HG and the number of postponed and terminated subsequent pregnancies due to HG. We also aimed to evaluate if there were predictive factors that could identify women at increased risk for HG recurrence, and postponing and terminating subsequent pregnancies. Material and methods: We conducted a prospective cohort study. A total of 215 women admitted for HG to public hospitals in the Netherlands were enrolled in the original MOTHER randomized controlled trial and associated observational cohort. Seventy-three women were included in this follow-up study. Data were collected through an online questionnaire. Recurrent HG was defined as vomiting symptoms accompanied by any of the following: multiple medication use, weight loss, admission, tube feeding or if nausea and vomiting symptoms were severe enough to affect life and/or work. Outcome measures were recurrence, postponing, and termination rates due to HG. Univariable logistic regression analysis was used to identify predictive factors associated with HG recurrence, and postponing and terminating subsequent pregnancies. Results: Thirty-five women (48%) became pregnant again of whom 40% had postponed their pregnancy due to HG. HG recurred in 89% of pregnancies. One woman terminated and eight women (23%) considered terminating their pregnancy because of recurrent HG. Twenty-four out of 38 women did not get pregnant again because of HG in the past. Univariable logistic regression analysis identifying possible predictive factors found that having a western background was associated with having weight loss due to recurrent HG in subsequent pregnancies (odds ratio 12.9, 95% CI 1.3–130.5, p = 0.03). Conclusions: High rates of HG recurrence and a high number of postponed pregnancies due to HG were observed. Women can be informed of a high chance of recurrence to enable informed family planning.
KW - hyperemesis gravidarum
KW - induced abortion
KW - pregnancy outcome
KW - recurrence
KW - reproductive behavior
KW - risk assessment
KW - risk factors
KW - secondary prevention
UR - http://www.scopus.com/inward/record.url?scp=85108845975&partnerID=8YFLogxK
U2 - 10.1111/aogs.14197
DO - 10.1111/aogs.14197
M3 - Article
C2 - 34033123
AN - SCOPUS:85108845975
SN - 0001-6349
VL - 100
SP - 1636
EP - 1643
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
IS - 9
ER -